Pharmacological Management Options to Prevent and Reduce Ischemic Hemorrhagic Transformation

被引:9
|
作者
Ho, Wing Mann [1 ,2 ]
Reis, Cesar [1 ,3 ]
Akyol, Onat [1 ]
Akyol, Gokce Yilmaz [1 ]
Applegate, Richard, II [3 ]
Stier, Gary [3 ]
Martin, Robert [3 ]
Zhang, John H. [1 ,3 ,4 ]
机构
[1] Loma Linda Univ, Dept Physiol & Pharmacol, Med Ctr, Loma Linda, CA 92354 USA
[2] Med Univ Innsbruck, Dept Neurosurg, Innsbruck, Austria
[3] Loma Linda Univ, Dept Anesthesiol, Med Ctr, Loma Linda, CA 92354 USA
[4] Loma Linda Univ, Dept Neurosurg, Med Ctr, 11234 Anderson St,Room 2562B, Loma Linda, CA 92354 USA
关键词
Cerebral ischemia; conversion; hemorrhagic transformation; prevention; stroke; treatment; BLOOD-BRAIN-BARRIER; TISSUE-PLASMINOGEN ACTIVATOR; FOCAL CEREBRAL-ISCHEMIA; ENDOTHELIAL GROWTH-FACTOR; FREE-RADICAL SCAVENGER; OXYGEN-GLUCOSE DEPRIVATION; SULFONYLUREA RECEPTOR 1; PRIOR STATIN USE; INTRACEREBRAL HEMORRHAGE; ARTERY OCCLUSION;
D O I
10.2174/1389450117666160818115850
中图分类号
R9 [药学];
学科分类号
1007 ;
摘要
Background: Hemorrhagic transformation (HT) is a common and natural complication after acute ischemic stroke. The only FDA-approved treatment so far for acute ischemic stroke is rapid reperfusion with recombinant tissue plasminogen activator (rtPA). Although it has been shown to exaggerate the risk and severity of HT and to be associated with increased morbidity and mortality. Objective: The aim of this review is to discuss the multifactorial pathophysiology of hemorrhagic transformation, promising interventional targets, and pharmacological treatment options. Results and Conclusion: Understanding HT is essential to restore cerebral blood flow to ischemic brain by reperfusion therapy without causing this complication and additional brain injury. Therefore methods for the prevention and treatment of HT are needed. Although experimental studies showed promising results, clinical translation remains unsatisfactory to date.
引用
收藏
页码:1441 / 1459
页数:19
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